title: Novel use of glycopyrrolate (Robinul) in the treatment of anastomotic leak after repair of esophageal atresia and tracheoesophageal fistula.
abstract: Anastomotic leak after tracheoesophageal fistula repair is a well-known complication and can represent a challenging clinical scenario. We present the case of an infant girl with VACTERL syndrome who underwent repair of a type C esophageal atresia and tracheoesophageal fistula repair, which was complicated by an anastomotic leak. Glycopyrrolate (Robinul), an anticholinergic agent, was successfully used to decrease copious salivary secretion and promote spontaneous closure of the leak. This report represents the first description in the medical literature of the use of glycopyrrolate in the treatment of an esophageal anastomotic leak. Glycopyrrolate may be a useful adjunct in the management of anastomotic leak after tracheoesophageal repair.
authors.affiliation: Baylor College of Medicine, Michael E. DeBakey Department of Surgery, Houston, TX 77030, USA.
authors.forename: Shawn
authors.initials: S
authors.lastname: Mathur
authors.forename: Sanjeev A
authors.initials: SA
authors.lastname: Vasudevan
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Patterson
authors.forename: Saif F
authors.initials: SF
authors.lastname: Hassan
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Kim
mesh_terms: D001003:Anal Canal / Q000002:abnormalities; D057868:Anastomotic Leak / Q000601:surgery*; D015505:Chest Tubes; D003125:Colostomy; D004933:Esophageal Atresia / Q000000981:diagnostic imaging / Q000601:surgery*; D004944:Esophagoplasty; D004947:Esophagus / Q000002:abnormalities; D005260:Female; D006024:Glycopyrrolate / Q000494:pharmacology / Q000627:therapeutic use*; D006330:Heart Defects, Congenital; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000002:abnormalities; D017880:Limb Deformities, Congenital; D018727:Muscarinic Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D011182:Postoperative Care; D011859:Radiography; D012472:Salivation / Q000187:drug effects*; D013131:Spine / Q000002:abnormalities; D013907:Thoracostomy; D014132:Trachea / Q000002:abnormalities; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D018727:Muscarinic Antagonists; D006024:Glycopyrrolate